title: Does intravenous fish oil benefit patients post-surgery? A meta-analysis of randomised controlled trials.
abstract: OBJECTIVE
  Supplementation of fish oil (FO) containing lipid emulsions has been associated with a reduction in the length of hospital stay, infections and liver dysfunction in patients undergoing major surgery. We carried out a meta-analysis and subgroup analysis to examine randomised clinical trial (RCT)-based evidence of the aforementioned effects.
  
  
  METHODS
  Four databases, reference lists and the WHO ICTRP were systematically searched for RCTs to access the clinical efficacy of fish oil-enriched total parenteral nutrition in post-surgery patients. Methodological quality assessment was based on the Cochrane Handbook and GRADE.
  
  
  RESULTS
  Twenty-one RCTs were enrolled for meta-analysis. FO was associated with a significant reduction in the length of hospital stay (mean = -2.14 d, 95% CI = -3.02 to -1.27), infections (OR = 0.53, 95% CI = 0.35-0.81), ALT (mean = -6.35 U/L, 95% CI = -11.75 to -0.94), GGT (mean = -11.01 U/L, 95% CI = -20.77 to -1.25) and total bilirubin (mean = -2.06 μmol/L, 95% CI = -3.6 to -0.52), as well as a non-significant change in mortality and postoperative medical cost. The quality of evidence of each clinical outcome was accessed as high.
  
  
  CONCLUSIONS
  FO-enriched lipid emulsions are likely to reduce infections, the length of hospital stay and liver dysfunction without influencing mortality and may be a safe and preferable choice in post-surgery patients. Further well-designed trials should be performed to determine whether FO lipid emulsions reduce mortality in patients undergoing hepatic surgery, especially liver transplantation, and the cost effectiveness of such treatment.
authors.affiliation: Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Ning-Ning
authors.initials: NN
authors.lastname: Li
authors.affiliation: Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Xian-Peng
authors.initials: XP
authors.lastname: Qin
authors.affiliation: Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Dan
authors.initials: D
authors.lastname: He
authors.affiliation: Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Jin-Yan
authors.initials: JY
authors.lastname: Feng
authors.affiliation: Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China. Electronic address: xiaoting_wu@yeah.net.
authors.forename: Xiao-Ting
authors.initials: XT
authors.lastname: Wu
mesh_terms: D061605:Administration, Intravenous; D016208:Databases, Factual; D019587:Dietary Supplements; D005395:Fish Oils / Q000008:administration & dosage*; D006801:Humans; D007902:Length of Stay; D008107:Liver Diseases / Q000517:prevention & control; D016031:Liver Transplantation / Q000401:mortality; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic
chemical_list: D005395:Fish Oils
keywords: Fish oil; Meta-analysis; Surgery; Systematic review; n-3 PUFA